A pivotal bone screw assembly includes a receiver having a central bore with a bottom opening and a channel for receiving an elongate rod, with the central bore including a partial spherical internal surface adjacent the bottom opening and a horizontally-extending recess with a cylindrical sidewall surface. The assembly also includes a shank with a capture structure for positioning within the central bore and an anchor portion for attachment to the bone, with the capture structure having a partial spherical lower surface configured to slidably engage the internal surface of the central bore to provide for pivotal motion of the shank with respect to the receiver, together with an insert with a rod seating surface and an outwardly-projecting radiused structure, with the insert being downwardly displaceable within the central bore until the radiused structure snaps into the recess to prevent upward movement of the insert with respect to the receiver.

Hydraulically expandable spinal rods and methods of use thereof are disclosed. The spinal rod may include a piston rod, a static rod, and a hydraulic pressure chamber for accepting hydraulic fluid and causing the piston rod to move in an expansion direction relative to the static rod. Upon connection of the piston and static rods to a patient's spinal column, the hydraulic spinal rod may be expanded to aid in correction of an underlying spinal deformity.

A spinal stabilization device that can be used to non-invasively correct spacing and curvature between at least two vertebral structures. The spinal stabilization device includes two telescoping tubes wherein ends of the two tubes can have pedicle screws that can be fastened to two or more vertebral bones. The overall length of the spinal stabilization device can be adjusted by moving the inner tube within the outer tube. Both the outer tube and the inner tube have multiple holes for receiving fasteners, wherein a fastener can be inserted through a hole in the outer tube into a hole in the inner tube for interlocking the inner tube and outer tube. The extension of the fastener into the holes and retraction from the holes can be controlled non-invasively from an external source. When the fastener is disengaged, the inner tube and the outer tube can freely move relative to each other, and the positions of the two or more vertebral bones can be non-invasively adjusted by subjecting a person to predefined movements and body posture. Upon achieving the desired positions, the fastener can be engaged to interlock the inner tube and the outer tube.

A tool set for implanting bone screws in a human spine, followed by the implantation of a rod into the bone screws includes end guide tools having flexible back wall flaps that receive opposite ends of the rod and intermediate guide tools that hold the rod in intermediate locations between the end guide tools. Both the end and intermediate guide tools include an attachment structure for operably connecting the guide tool to a bone screw. The attachment structure includes an undercut and/or recess so as to resist splaying and separation of the guide tool from an attached bone screw.

Implants, systems, and methods for securing a flexible band, thereby providing a desired correction to the spine. The implant may secure the flexible band to a spinal rod and/or a pedicle screw. The implant has a locking mechanism to secure the band. The band may be looped around bony anatomy and tensioned to achieve correction and provide fixation as an alternative or supplement to pedicle screws and spinal rods during spinal deformity surgery. Tensioners may be used that allow for multiple positions for attachment between the tensioner and a band clamp inserter.

A receiver assembly for securing an elongate rod to a bone anchor includes a receiver having a channel configured to receive the elongate rod, a helically wound receiver guide and advancement structure formed into the interior surfaces of the receiver. The receiver assembly further includes a fastener configured for positioning within the channel to secure the elongate rod to the receiver in a locked configuration, with the fastener having an outer surface with a mating continuous helically wound guide and advancement structure configured for rotatable engagement with the receiver guide and advancement structure.

A pivotal bone anchor assembly for securing an elongate rod to a bone of a patient. The assembly includes a receiver having pair of upright arms that define an open channel configured to receive the elongate rod and a discontinuous helically wound receiver guide and advancement structure formed into the interior surfaces of the upright arms. The assembly further includes a closure configured for positioning within the open channel to secure the elongate rod to the receiver in a locked configuration, with the closure having an outer surface with a mating continuous helically wound closure guide and advancement structure configured to resist a tendency toward splaying between the upright arms upon a screwing in of the closure within the open channel by rotatable engagement with the receiver guide and advancement structure.

A bone anchor implant assembly configured for surgical implantation into a bone of a patient. The bone anchor implant assembly includes an elongate rod, a separate shank and head, and a closure mechanism configured as a one-part closure or two-part closure. The one-part closure and two-part closure are configured to be interchangeable with each other for closing a channel of the head and locking the assembly and the elongate rod between arms of the head with the closure mechanism.

A method is provided for determining the shape of a surgical linking device that is to be attached to a bony body structure such as the spinal column based on digitized locations of a plurality of attachment elements engaged to the bony structure. The method is implemented by a computer system through a GUI to generate an initial bend curve to mate with the plurality of attachment elements. The initial bend curve may be simplified based on user input to the GUI to reduce the number of bends necessary to produce a well-fitting linking device and may be altered to help obtain the goals of surgery.

A pivotal bone anchor assembly includes a receiver having an axial bore with a lower seating surface adjacent a bottom opening, and a bone anchor having a capture portion uploadable through the bottom opening with a spherical outer surface and a pair of opposite planar side surfaces. The assembly also includes a multi-part retainer comprising at least two discrete retainer parts, each having an internal planar surface for engaging a planar side surface of the capture portion within the axial bore, and a compression insert having a lower curvate surface for engaging the spherical outer surface of the capture portion and opposite parallel planar side surfaces for engagement by rotation blocking structures extending into the axial bore. Upon an application of downward force onto the multi-part retainer, outer surfaces of the retainer parts frictionally engage the lower seating surface to lock an angular orientation of the bone anchor with respect to the receiver.